Hip Avulsion Fractures

Introduction

  • Can be the result of macrotrauma or microtrauma
  • Avulsion around the hip have been documented in the adductors (Morelli 2001), sartorius (Beck 2003; Thanikachalam 1995), rectus femoris (Nanka 2003; Meyer 2001), iliopsoas (Morelli 2001), and biceps femoris (Koulouris 2003)
  • They can be the result of hip joint subluxation (Meyer 2001)
  • Avulsion injuries of the pelvis are common among adolescent participants in organized sports
  • In adolescents, muscles and tendons are stronger than the apophysis.
  • Acute avulsion fractures of the pelvis result from extreme, unbalanced, and eccentric muscular contractions (Stevens 1999)

Clinical Presentation and Diagnosis

  • Complete avulsion presents with severe initial pain during the trauma followed by reduced pain and increased weakness
  • Incomplete avulsion presents with persistant pain and weakness
  • Can be diagnosed by MRI or diagnostic ultrasound
  • Point tenderness and swelling are noted over the avulsion site. A lump may be palpated which represents the avulsion fragment

Treatment

  • Conservative management is preferred consisting of 4 to 6 weeks of rest
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